الفهرس 
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Abstract
This study was done to investigate the immunomodulatory role of VD in ITP.
It was carried out on 80 patients with ITP. Our patients were taken from hematology unit and clinic, pediatrics department, Maternity & Children Hospital, Minia University in a period from August 2018 to February 2019. Our Patients were divided into:
group I : It includes 40 children with acute ITP (22 males and 18 females). Their ages ranged from 1 to 10 years. Patients in this group were subdivided into:
group I.A: 20 children with VD supplementation.
group I.B: 20 children without VD supplementation.
group II: It includes 40 children with chronic ITP (19 males and 21 females). Their ages ranged from 2 to 11 years. Patients in this group were subdivided into:
group II .A: 20 children with VD supplementation.
group II .B: 20 children without VD supplementation.
The studied groups were subjected to the following:
1) Careful history taking and clinical examination.
2) Laboratory investigations:
A. Routine investigations:
CBC, Urea, creatinine, ALT& AST, PT, PC
Bone marrow aspiration was done for all cases.
B. Special investigations: Serum VD (25-OH vitamin D) level.
3) Supplementation with vitamin D3 (25,000 IU) for 6 weeks for subgroups A.
4) Follow up of platelets count and clinical response to VD treatment.
The results of this study were summarized as follows:
Patients’ Ages ranged from 1.2 to 11 years. There was no significant difference regarding gender of patients. Rural cases represented 86.3 % of cases.
Pallor was noted with 23.8% of patients. Coomb’s test was negative for all cases. Petechiae and ecchymosis were present in all cases. The most common mucosal bleeding was epistaxis followed by oral bleeding.
The Correlation between age of patients and disease duration revealed positive correlation.
All patients in our study have VD deficiency. Only one case with normal level was excluded. After supplementation, VD level increased significantly up to adequate level. Mean platelets number was significantly higher after VD supplementation than before taking VD in both patients with acute or chronic ITP.
There was statistical significant difference in mean platelets count between the group received VD, and the other group without VD supplementation.
There is a significant difference between length of hospital stay in patients received VD and other patients.
There is a significant negative correlation between length of hospital stay and platelets count, patients with higher platelets count stayed less days.
By the end of the study, we found that VD plays an important role in ITP cases. VD supplementation is effective in improving platelets count. Thereby, we recommend VD assay for ITP cases and VD supplementation for deficient cases.